Provider Demographics
NPI:1629039987
Name:DUCHMANN, ERICH G (PHD, MP)
Entity Type:Individual
Prefix:
First Name:ERICH
Middle Name:G
Last Name:DUCHMANN
Suffix:
Gender:M
Credentials:PHD, MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7738 DON BUDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1710
Mailing Address - Country:US
Mailing Address - Phone:225-292-0155
Mailing Address - Fax:844-715-7911
Practice Address - Street 1:7738 DON BUDGE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1710
Practice Address - Country:US
Practice Address - Phone:225-292-0155
Practice Address - Fax:844-715-7911
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA305159103TP0016X, 103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T966Medicare ID - Type UnspecifiedMEDICARE PROVIDER #